PubMed · 15022418
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Catherine Jackson. 2004. Why not?. https://pubmed.ncbi.nlm.nih.gov/15022418/
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This paper reviews Latin American neoliberal health reforms sponsored by the IMF and the World Bank, and analyzes the impact on the region of decentralization and privatization, the two basic components of the reforms. The second part of the paper examines in some detail the Chilean and Colombian reforms, the two countries that have implemented closely the principles of the neoliberal reform. The two case studies confirm that neoliberal reforms do not improve quality of care, equity, and efficiency. In the discussion the authors identify the beneficiaries of the reforms: transnational corporations, consultant firms, and the World Bank's staff. The recognition of the beneficiaries helps to explain some of the reasons behind the Word Bank continuing pressures to implement neoliberal health reforms in spite the growing evidence of their failures.
In early 1995, Israel implemented a healthcare reform. The course of any such reform depends largely on the strengths and interests of different stakeholders in the health system and their roles during the implementation phase. This paper discusses the roles of stakeholders in the recent Israeli healthcare reform, analyzes their motives, and describes their impact on the course of the reform. In retrospect, the Israeli healthcare reform had a profound effect on the country's overall healthcare environment and involved significant social, cultural, and financial changes and advancements. However, imbalances among stakeholders in the health system caused several aspects of the reform to stray from the original plan. Thus, in the first few years after the reform only first steps were taken toward the fulfillment of the vision of the reform, an equitable healthcare system that meets the health needs and welfare of the population from cradle to grave. A study of the stakeholders may further our understanding of the process of health-reform implementation.